I had a Ht. attack in 2000, at the time my heart was pumpking at 20%, that test was a Echo, 2001 I had a Nuclear St. test and is was up to 39% I was told, in 2002 enother nuclear and I was told it was at 53, I lost my job and had no insurance so I didn't visit a cardiologist for a few years, I went a few weeks ago and had an Echo and it's down to 30. I had moved so the new Dr. he is changing all meds and seems to be getting all uptight, I looked at my past notes of my old tests and he is right sort of. When I had the nuclear at rest it was lower but while walking fast is was almost normal in the low 50's. My past Dr's were not that concerned because I was very active. He's putting me on Toprol and removing the Atenolol and has doubled my Accupril. I feel ok no difference over the last 5 years. My concern is when my blood press. goes below 105-110 over the low 60 I can't function, I've also always had a slow Ht Rate so when that hits the low to mid 50's again I can't function.
Also I've been told the Nuclear Test is the most accurate at measuring the heart action is this true since the to Echo's were very low ? Maybe this last Echo wasn't that accurate ?
Thanks in advance!

Hi vooda,

Cardiac output (EF) will change depending on the resistance the heart is pumping against (afterload). The heart pressures, heart dimensions, heart wall thickness will influence preload (filling) and if abnormal will compromise CO.

An echo will provide heart dimensions and a good source for an EF estimate. An angiogram is good source for determining pressures. I had an EF (according to written report) of 29% when entering ER. The next day with an angiogram the report states an EF of 13%.:confused:

If you had a heart attack (MI), there probably was heart muscle damage. It would impair pumping contractions and a lower CO. This would cause your system to compensate by enlarging the heart and wall thickness would increase, etc. If your medication is appropriate, it should reduce preload and afterload resulting in a more efficient CO, and there should be stability to your condition.

If the echo is less accurate it is because the outer and inner margins are somewhat "fuzzy" and the dimensions may be slightly inaccurate (resulting in smaller or larger borders outlined manually with a transducer for equipment software to calculate). But at the very most only an error of 10%.

One can feel absolutely well with an EF below 29% and with medication to increase the EF feel less well. Not unusual at all. The medication improves longevity but for some people there is an intolerance.

I just read the book "Stop Inflamation Now" by Richard Fleming. It was amazing when it comes to treating heart disease. He is a nuclear cardiologist that believes, and has proved that these conditions can be overcome with proper diet and exercise. Im not trying to push his book, but it has a lot of helpful info that is not generally known.

Thanks
I sometimes prefer personal stories to Dr's stories. Not the treatment of course.
I was just concerned at the difference in the rates given to me between the Echo and the Nuclear tests they seem to have a large difference, both times as well the echo doesn't take into account the working load of the heart. :confused: My other Dr's seem to think that was important since we don't lie on a table our whole lives, and they took into account the activity level of a person, since I'm only now 44 and do like to be active. :eek:
Also I've heard many horor stories about topal again I prefer personal experiences of someone who actually lives the life.

Thank you for the feedback ! :)

I have always been struck by the complexity of estimating EF by any method at all. It just seems to me very hit-or-miss and I think the most valid result is probably that gotten by an average of various methods.

It's hard enough to measure the flow in a steel pipe; inside a living breathing person seems tough work indeed.

The computerized MRI methodology using the flow of an isoptope past a point seem the best to me, but not readily available.